多途径抗真菌治疗在泌尿生殖道粪石管理中的应用
Multi-route antifungal administration in the management of urinary bezoar.
作者信息
Viswambaram Pravin, Misko Jeanie, Rawlins Matthew, Clark Sarah, Dyer John, Hayne Dickon
机构信息
Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA, 6150, Australia.
University of Western Australia, UWA Medical School, 35 Stirling Highway, Perth, WA, 6009, Australia.
出版信息
Urol Case Rep. 2020 May 23;33:101275. doi: 10.1016/j.eucr.2020.101275. eCollection 2020 Nov.
A 65-year-old lady was admitted with urosepsis and imaging suggesting right sided hydronephrosis secondary to a filling defect consistent with a fungal bezoar. An indwelling urinary catheter and a right percutaneous nephrostomy tube were inserted. Candida glabrata cultured from urine was resistant to fluconazole. Amphotericin B was instilled into the renal pelvis via the nephrostomy tube while intravenous liposomal amphotericin was administered daily along with oral flucytosine. This multi-modal antifungal administration was continued for 14 days. Clinical and biochemical improvement was achieved and repeat imaging showed complete resolution of the filling defects and hydronephrosis.
一位65岁女性因尿脓毒症入院，影像学检查提示右侧肾盂积水，继发于与真菌粪石相符的充盈缺损。插入了留置导尿管和右侧经皮肾造瘘管。尿培养出的光滑念珠菌对氟康唑耐药。通过肾造瘘管将两性霉素B注入肾盂，同时每日静脉给予脂质体两性霉素，并口服氟胞嘧啶。这种多模式抗真菌治疗持续了14天。临床和生化指标得到改善，重复影像学检查显示充盈缺损和肾盂积水完全消退。
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